Ann Palliat Med:肝切除术中围手术期使用乌司他丁对肝功能有保护作用

2021-02-28 MedSci原创 MedSci原创

肝切除术中血管闭塞伴随着缺血再灌注(IR)损伤,可引起肝功能障碍,影响患者的治疗效果。乌司他丁(UTI)是一种多种酶的多价抑制剂,近来的研究证实了其抗IR损伤的作用。近日,来自中国的学者进行了一项系统

肝切除术中血管闭塞伴随着缺血再灌注(IR)损伤,可引起肝功能障碍,影响患者的治疗效果。乌司他丁(UTI)是一种多种酶的多价抑制剂,近来的研究证实了其抗IR损伤的作用。近日,来自中国的学者进行了一项系统回顾和荟萃分析,评估了肝切除术中围手术期使用UTI对肝功能保护的益处,研究结果已发表于Ann Palliat Med。

研究人员确定了评价肝切除术中UTI的随机对照试验(RCTs)。两名独立审稿人提取了研究的基本特征和偏倚风险,以及术后1~7天丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)和总胆红素(TBIL)等结果的数据。

 

最终共确定了9项RCTs,包括408名UTI参与者和372名对照参与者。年龄、性别等基本特征无显著差异。接受肝切除术的患者大多存在原发性肝癌、肝转移和肝脏良性病变。肝功能的显著改善不仅与术后1天和3天的UTI使用有关,而且与7天的UTI使用有关(均P≤0.01)。所纳入的研究之间存在明显的异质性(均P<0.01)。

综上所述,该研究结果表明,UTI对肝切除术中IR损伤有积极的保护作用。然而,还需要进一步的高质量RCTs来证实这一结论。

 

原始出处:

 

Hong Gao, Yi Lyu, et al., Perioperation ulinastatin intervention protects liver function in hepatectomy: a systematic review of randomized controlled trials and meta-analysis. Ann Palliat Med. 2020 May;9(3):774-787. doi: 10.21037/apm.2020.04.28.

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    2022-02-10 changfy
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[GetPortalCommentsPageByObjectIdResponse(id=1763374, encodeId=845e1e633747a, content=<a href='/topic/show?id=6ec1253186b' target=_blank style='color:#2F92EE;'>#他丁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25318, encryptionId=6ec1253186b, topicName=他丁)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7d6637506150, createdName=ms2694732865965676, createdTime=Thu Jun 03 03:13:15 CST 2021, time=2021-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1926422, encodeId=65be192642261, content=<a href='/topic/show?id=a6ba8118009' target=_blank style='color:#2F92EE;'>#肝切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81180, encryptionId=a6ba8118009, topicName=肝切除)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Thu Feb 10 03:13:15 CST 2022, time=2022-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877386, encodeId=086618e73864f, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Mon Jul 05 11:13:15 CST 2021, time=2021-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053905, encodeId=5df32053905ff, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/WQ1WyMBGic8d2fKdCe6Cm3vaRh4X8YnlumYndC46iagNCBl9Df8RtoCaQchnFtZldHUctGJjsgsyutUlu8vPq6yQ/132, createdBy=97862500016, createdName=ms3117646317107274, createdTime=Sat Jul 10 07:13:15 CST 2021, time=2021-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1329477, encodeId=23c513294e7c0, content=<a href='/topic/show?id=bb96232801' target=_blank style='color:#2F92EE;'>#ALL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2328, encryptionId=bb96232801, topicName=ALL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Tue Mar 02 11:13:15 CST 2021, time=2021-03-02, status=1, ipAttribution=), 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createdName=zexyw02, createdTime=Tue Mar 02 11:13:15 CST 2021, time=2021-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1599153, encodeId=ea5f1599153f1, content=<a href='/topic/show?id=f14d2e187ac' target=_blank style='color:#2F92EE;'>#保护作用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27187, encryptionId=f14d2e187ac, topicName=保护作用)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ee918684940, createdName=photoman, createdTime=Tue Mar 02 11:13:15 CST 2021, time=2021-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610936, encodeId=2f021610936f4, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Mar 02 11:13:15 CST 2021, time=2021-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944503, encodeId=7671944503e8, content=请问,UTI对肝硬化慢性肝衰竭效果如何,有这方面的研究吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210301/28e81c1eda64491ea0507710c5173138/2e20c197213f4d2bb2c03374b04301e6.jpg, createdBy=bfa51746861, createdName=ms8609978862674887, createdTime=Mon Mar 01 17:02:55 CST 2021, time=2021-03-01, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1763374, encodeId=845e1e633747a, content=<a href='/topic/show?id=6ec1253186b' target=_blank style='color:#2F92EE;'>#他丁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25318, encryptionId=6ec1253186b, topicName=他丁)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7d6637506150, createdName=ms2694732865965676, createdTime=Thu Jun 03 03:13:15 CST 2021, time=2021-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1926422, encodeId=65be192642261, content=<a href='/topic/show?id=a6ba8118009' target=_blank style='color:#2F92EE;'>#肝切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81180, encryptionId=a6ba8118009, topicName=肝切除)], attachment=null, authenticateStatus=null, createdAvatar=, 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createdName=zexyw02, createdTime=Tue Mar 02 11:13:15 CST 2021, time=2021-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1599153, encodeId=ea5f1599153f1, content=<a href='/topic/show?id=f14d2e187ac' target=_blank style='color:#2F92EE;'>#保护作用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27187, encryptionId=f14d2e187ac, topicName=保护作用)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ee918684940, createdName=photoman, createdTime=Tue Mar 02 11:13:15 CST 2021, time=2021-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610936, encodeId=2f021610936f4, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Mar 02 11:13:15 CST 2021, time=2021-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944503, encodeId=7671944503e8, content=请问,UTI对肝硬化慢性肝衰竭效果如何,有这方面的研究吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210301/28e81c1eda64491ea0507710c5173138/2e20c197213f4d2bb2c03374b04301e6.jpg, createdBy=bfa51746861, createdName=ms8609978862674887, createdTime=Mon Mar 01 17:02:55 CST 2021, time=2021-03-01, status=1, ipAttribution=)]
    2021-03-02 膀胱癌
  6. 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  7. 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  8. 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  9. 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encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Mar 02 11:13:15 CST 2021, time=2021-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944503, encodeId=7671944503e8, content=请问,UTI对肝硬化慢性肝衰竭效果如何,有这方面的研究吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210301/28e81c1eda64491ea0507710c5173138/2e20c197213f4d2bb2c03374b04301e6.jpg, createdBy=bfa51746861, createdName=ms8609978862674887, createdTime=Mon Mar 01 17:02:55 CST 2021, time=2021-03-01, status=1, ipAttribution=)]
    2021-03-02 hb2008ye
  10. 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    2021-03-01 ms8609978862674887

    请问,UTI对肝硬化慢性肝衰竭效果如何,有这方面的研究吗

    0

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